How to Treat Seasonal Affective Disorder

How to treat SAD

When daylight saving time ends, we gain an extra hour of sleep but lose something precious: sunlight. As daylight slips into darkness earlier in the day, depression diagnoses increase, according to a 2016 study published in Epidemiology. An estimated 5% of Americans slump into a type of depression known as seasonal affective disorder, or SAD. Millions more experience the “winter blues,” a milder form of seasonal depression.

Obviously, you can’t control seasonal changes, but going into hibernation during the fall and winter is not the solution. “If you wake up and you want to pull the covers over your eyes, that’s the worst thing to do,” says Norman Rosenthal, MD, clinical professor of psychiatry at Georgetown University School of Medicine in Washington, D.C. He says the best thing to do is exactly the opposite: “Get more light, get out of bed, get active.”

While very depressed people may need to see a physician or therapist, many cases of seasonal depression can be self treated, adds Dr. Rosenthal, a pioneer in the field of SAD research.

Read on to learn about some tried-and-true treatment methods, plus a few strategies that may be worth giving a whirl if you have seasonal affective disorder.

Try light therapy

A daily dose of bright light, especially in the morning, has been shown in multiple studies to be an effective, mood-elevating therapy. It’s one of the main treatments for people with SAD and is thought to help make up for the lack of natural light people get during colder, darker months.

“When light hits the retina of the eye, it’s converted into nerve impulses that pass back to specialized regions of the brain that are involved in emotional regulation,” explains Dr. Rosenthal, lead author of the first-ever report describing seasonal affective disorder and the use of light therapy as a treatment.

You’ll find any number of bright-light-emitting lamps and light boxes on the market for this purpose. Treatment involves 20 to 60 minutes of daily exposure to cool-white florescent light, according to the National Institute of Mental Health.

Catch some rays

Seasonal affective disorder strikes when there’s a dearth of natural light, usually during the fall and winter months. So it stands to reason that soaking in sunlight on a bright fall or winter day may help lift people from their seasonal despair.

So bundle up and bask in nature’s brilliance. “You’re getting a lot of light coming into the eyes that way,” Dr. Rosenthal explains.

Exercise

A regular workout routine is great for body and mind. Heart-pumping exercise reduces symptoms of depression in general and also benefits people with SAD. There are many theories as to why exercise improves mood: It may raise levels of “feel good” neurotransmitters in the brain, it may promote the growth of brain cells, or it may simply have a meditative effect. Studies show exercise is even better when combined with light. “That could be a brisk walk on a sunny day or the exer-cycle in front of a light box,” Dr. Rosenthal says.

Consider antidepressants

Two types of prescription medicines have been shown to help people cope with seasonal affective disorder. One option is a selective serotonin reuptake inhibitor, or SSRI. These prescription antidepressants work by boosting serotonin levels in the brain.

Generic bupropion (Wellbutrin and Budeprion) is another option. It improves mood by boosting brain levels of three different chemical messengers: dopamine, serotonin, and norepinephrine. Extended-release bupropion taken early in the fall before seasonal depression set in reduced recurrence of depressive symptoms in SAD patients compared with a placebo in three studies.

These drugs carry risks of side effects, including suicidal thoughts and behavior in some children, teens, and young adults, and may not be the right treatment for everyone.

Try cognitive behavioral therapy

Of all the different types of psychotherapy, cognitive behavioral therapy (CBT) “has the most going for it,” Dr. Rosenthal writes in his book, Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder. CBT helps seasonal depression sufferers replace negative thoughts, feelings, and behaviors with positive thinking and actions.

The cognitive part is recognizing that SAD isn’t a personal deficit, Dr. Rosenthal explains. “It’s part of your genetic makeup and your response to the seasons and light, so you don’t have to blame yourself,” he says. The behavioral part is taking time for yourself to do something you enjoy, like practicing yoga or grabbing lunch with a friend.

Ditch junk food

When you’re stuck in a seasonal funk, it’s tempting to reach for sweet and starchy comfort foods. Sure, you’ll get an immediate energy boost. But the feeling isn’t sustained, and those sugar binges can pack on the pounds.

A large study found women who consumed the most refined carbs, found in picks like white bread, white rice, and soda, had higher blood sugar levels and were at greater risk of depression (although not SAD specifically). Those with higher fruit, vegetable, and whole grain intake had a lower incidence of depression.

Manage stress

If seasonal depression saps your energy every winter, don’t let yourself become overwhelmed. Adapt by lightening your load, Dr. Rosenthal says. “Let’s say you’re used to making a big Christmas, and it’s so stressful. Well, take everybody to a restaurant, and decide to have your big party in the spring or summer,” he says.

Other stress management techniques can help you cope with seasonal depression as well, including practicing meditation, scheduling big projects and deadlines for the summer, and taking breaks to walk outside in the sun.

Take a warm winter vacation

Dreary New England winters bringing you down? A change of venue might help.

“Many of my patients have learned that if they have a choice, it’s better to take vacations in winter than in summer,” Dr. Rosenthal writes in a chapter of his book on alternatives to light therapy. “Two weeks in a sunny climate in January can effectively interrupt the worst stretch of winter,” he writes.

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